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To Sleep Better, Make Your Own Placebo

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Wouldn’t it be great if you could just take a “sugar pill” to get to sleep?

Maybe you can. Recent research has shown that placebos—sugar or other non-active material given to patients in place of actual drugs—make good sleep medicine. About half of the effectiveness of prescription sleep medications comes from the placebo effect, research shows. The “real” drugs, meanwhile, may leave us groggy, memory-impaired and more accident-prone—and can lead to a drug dependency. They are widely overprescribed, especially amongst the elderly.

But if you know you’re just taking a sugar pill, is it really a placebo? Don’t you need to believe you’re really taking a sleeping pill for the placebo effect to work?

One French doctor has devised a clever method that lets his patients use the power of the placebo to wean themselves from reliance on prescription or over-the-counter sleeping pills. Here’s how you can do it yourself…

THE POWER OF PLACEBOS

First, a little background. The term placebo (Latin for “I shall please”) has been used to refer to medicine for more than two centuries (Thomas Jefferson wrote about them), but most physicians believed these inert pills exerted no real physiological action—they simply allowed patients to fool themselves into feeling better.

Now we know better. The belief that you are taking medicine can unleash powerful, positive physical changes in your body. “A host of studies have shown that treatment with placebos elicits an array of physiological responses,” says Harvard Medical School professor Ted J. Kaptchuk, who directs the Program in Placebo Studies at Beth Israel Deaconess Medical Center in Boston. “These include stimulating neurotransmitters such as the body’s own opioids, cannabinoids, dopamine and serotonin, all of which can alleviate pain, depression, anxiety and fatigue. We have an entire pharmacy of substances within us—and placebos help trigger their action.”

YOUR RECIPE FOR ZZZS?

Patrick Lemoine, MD, a professor of psychiatry at the University of Claude Bernard of Lyon in France, finds that many of his patients have trouble letting go entirely even if they have cut back. For them he uses homemade placebos to wean his patients off prescription pills. “It’s a bit like when a child learns to swim and refuses to let go of a floating device the instructor has gradually deflated,” he writes.

His weaning technique entails transferring prescription sleep medication into empty capsules and doing the same with sugar, then mixing the drug capsules and sugar capsules together so that on any given night, you won’t know whether you’re taking a real or fake pill. 

Below is a plan based on his recommendations for patients who are used to taking a sleeping pill every night.

Make sure to first ask your pharmacist whether your prescription sleeping tablets can be safely crushed and ingested in capsules…

• First, gather your materials. Buy a bag of at least 150 empty capsules—choose the opaque sort over the clear—at your drugstore or online. Next, you’ll need sugar, or, if you’d rather not take in even a tiny amount of sugar, you can substitute cornstarch. Finally, you’ll need something with which to crush your sleeping pills—a mortar-and-pestle or, if you prefer, a capsule-filling kit (easily found online).

• Next, count out 30 empty capsules. Insert one finely crushed sleeping pill into each of 25 of the capsules. Now put about the same amount granulated sugar or whatever placebo material you have chosen into each of the remaining five capsules.

• Put all of the capsules in a jar or empty pill bottle, and shake gently to mix them around.

• For the next month, take one capsule from this bottle each night. On any given night, you won’t know whether you’ve taken the sleeping drug or a placebo. But you will know that on any given night, there’s a very good chance that you are taking the sleeping drug, because 25 out of the 30 capsules contain the drug.

• The second month, fill 20 capsules with the sleep aid and 10 with the placebo.

• The third month, make it even-steven—15 drug-filled caps, 15 placebo-filled caps. For the fourth month, it’s 10 drugs/20 placebos. Fifth month: Five drugs/25 placebos. For the last month, one drug/29 placebos.

By the end of the process, if all goes well, you’ll be sleeping like a baby with almost no help from drugs. You may want to wean yourself from sleep drugs in just a few months rather than the full six, and that’s fine. What’s described above is not a scientifically proven method, but just one doctor’s approach that works for some of his patients, so feel free to adapt the approach as you see fit.

For example, there’s no reason to start taking a pill every night if you’re in the habit of taking sleeping pills only when you feel that you need them. In that case, mix up a batch of sleeping pills plus some number of placebos beforehand, and take one pill when you feel that you need a little help. And if you have trouble giving up the idea that you might be taking a sleeping pill, you could go back to the 5/25 or even the 1/29 formula. You’ll still be taking a lot fewer sleeping pills. (Note: If you’re traveling, especially if you’re flying, leave these pills at home. You won’t be able to show that they are prescription medicines if you are asked.)

Another approach: Try a half dose of your standard sleeping pills, either cut in half (check with your pharmacist to see if yours can be cut in half safely) or mixed in with placebos as above. You can also use the placebo effect to make other types of prescriptions work better. See Bottom Line’s article “Dr. Murray Grossan’s Secret to Making Any Medication Work Much, Much Better.”

Finally, it’s also possible that taking a placebo might work for you even if you know it’s a placebo. “We’ve done several studies using ‘open label’ or ‘honest’ placebos (where the person taking them knew they were ingesting an inactive substance) with very good results,” says Professor Kaptchuk.

In the end, learning to harness the power of placebos to get better sleep is really about activating your own abilities—and there are many paths you can take. See Bottom Line’s “Sleep Better with Cognitive Behavioral Therapy for Insomnia” and learn more in Bottom Line’s Guide to Better Sleep…No Sleeping Pills Needed.

 

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Source: Article titled “The Placebo Effect: History, Biology, and Ethics,” by Patrick Lemoine, MD, professor of psychiatry and director of clinical studies, University of Claude Bernard of Lyon, France, published in Medscape. Ted. J. Kaptchuk, director, Program in Placebo Studies, Beth Israel Deaconess Medical Center, Boston. Date: November 30, 2015 Publication: Bottom Line Health
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